PRINTER'S NO. 1626
No. 1196 Session of 2007
INTRODUCED BY FOLMER, EICHELBERGER AND PICCOLA, DECEMBER 7, 2007
REFERRED TO BANKING AND INSURANCE, DECEMBER 7, 2007
AN ACT
1 Amending the act of March 20, 2002 (P.L.154, No.13), entitled
2 "An act reforming the law on medical professional liability;
3 providing for patient safety and reporting; establishing the
4 Patient Safety Authority and the Patient Safety Trust Fund;
5 abrogating regulations; providing for medical professional
6 liability informed consent, damages, expert qualifications,
7 limitations of actions and medical records; establishing the
8 Interbranch Commission on Venue; providing for medical
9 professional liability insurance; establishing the Medical
10 Care Availability and Reduction of Error Fund; providing for
11 medical professional liability claims; establishing the Joint
12 Underwriting Association; regulating medical professional
13 liability insurance; providing for medical licensure
14 regulation; providing for administration; imposing penalties;
15 and making repeals," further providing for medical
16 professional liability insurance, for the Medical Care
17 Availability and Reduction of Error Fund; and in Health Care
18 Provider Retention Program, further providing for expiration;
19 and establishing the Health Care Provider Rate Stabilization
20 Fund.
21 The General Assembly of the Commonwealth of Pennsylvania
22 hereby enacts as follows:
23 Section 1. Section 711(d)(3) and (4) of the act of March 20,
24 2002 (P.L.154, No.13), known as the Medical Care Availability
25 and Reduction of Error (Mcare) Act, are amended to read:
26 Section 711. Medical professional liability insurance.
27 * * *
1 (d) Basic coverage limits.--A health care provider shall
2 insure or self-insure medical professional liability in
3 accordance with the following:
4 * * *
5 (3) [Unless the commissioner finds pursuant to section
6 745(a) that additional basic insurance coverage capacity is
7 not available, for] For policies issued or renewed in
8 calendar [year 2006 and each year thereafter] years 2008,
9 2009, 2010 and 2011 subject to paragraph (4), the basic
10 insurance coverage shall be:
11 (i) $750,000 per occurrence or claim and $2,250,000
12 per annual aggregate for a participating health care
13 provider that is not a hospital.
14 (ii) $1,000,000 per occurrence or claim and
15 $3,000,000 per annual aggregate for a nonparticipating
16 health care provider.
17 (iii) $750,000 per occurrence or claim and
18 $3,750,000 per annual aggregate for a hospital.
19 [If the commissioner finds pursuant to section 745(a) that
20 additional basic insurance coverage capacity is not
21 available, the basic insurance coverage requirements shall
22 remain at the level required by paragraph (2); and the
23 commissioner shall conduct a study every two years until the
24 commissioner finds that additional basic insurance coverage
25 capacity is available, at which time the commissioner shall
26 increase the required basic insurance coverage in accordance
27 with this paragraph.]
28 (4) [Unless the commissioner finds pursuant to section
29 745(b) that additional basic insurance coverage capacity is
30 not available, for] For policies issued or renewed [three
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1 years after the increase in coverage limits required by
2 paragraph (3)] in year 2012 and for each year thereafter, the
3 basic insurance coverage shall be:
4 (i) $1,000,000 per occurrence or claim and
5 $3,000,000 per annual aggregate for a participating
6 health care provider that is not a hospital.
7 (ii) $1,000,000 per occurrence or claim and
8 $3,000,000 per annual aggregate for a nonparticipating
9 health care provider.
10 (iii) $1,000,000 per occurrence or claim and
11 $4,500,000 per annual aggregate for a hospital.
12 [If the commissioner finds pursuant to section 745(b) that
13 additional basic insurance coverage capacity is not
14 available, the basic insurance coverage requirements shall
15 remain at the level required by paragraph (3); and the
16 commissioner shall conduct a study every two years until the
17 commissioner finds that additional basic insurance coverage
18 capacity is available, at which time the commissioner shall
19 increase the required basic insurance coverage in accordance
20 with this paragraph.]
21 * * *
22 Section 2. Section 712(d) is amended by adding a paragraph
23 to read:
24 Section 712. Medical Care Availability and Reduction of Error
25 Fund.
26 * * *
27 (d) Assessments.--
28 * * *
29 (4) For calendar year 2012 and for each calendar year
30 thereafter, all assessments shall cease and the fund shall be
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1 funded in accordance with section 1116.
2 * * *
3 Section 3. Section 1101 of the act is amended by adding a
4 definition to read:
5 Section 1101. Definitions.
6 The following words and phrases when used in this chapter
7 shall have the meanings given to them in this section unless the
8 context clearly indicates otherwise:
9 * * *
10 "Fund." The Health Care Provider Rate Stabilization Fund
11 established under section 1116.
12 * * *
13 Section 4. Section 1115 of the act, amended October 27, 2006
14 (P.L.1198, No.128), is amended to read:
15 Section 1115. Expiration.
16 The Health Care Provider Retention Program established under
17 this chapter shall expire December 31, [2008] 2007.
18 Section 5. The act is amended by adding a section to read:
19 Section 1116. Health Care Provider Rate Stabilization Fund.
20 (a) Declaration of policy.--The General Assembly finds and
21 declares as follows:
22 (1) Adequate numbers of health care providers for access
23 to quality health care must be available.
24 (2) Health care providers must be encouraged to practice
25 in this Commonwealth.
26 (3) The maintenance of a health care medical malpractice
27 marketplace is essential to these goals.
28 (4) The financial impact to health care providers as a
29 result of the transition to a private medical malpractice
30 marketplace must be mitigated.
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1 (b) Establishment.--Effective January 1, 2008, the Health
2 Care Provider Rate Stablilization Fund is established in the
3 State Treasury. Money in the fund shall be used for the
4 following purposes:
5 (1) Payment of any obligations as described in this
6 chapter.
7 (2) Effective January 1, 2012, payment of claims against
8 any participating providers for losses or damages awarded in
9 medical liability actions against them in accordance with
10 section 712(c).
11 (3) Payment of premiums and assessments for insurance
12 coverage as required in sections 711(d) and 712(c) in effect
13 for calendar year 2008 and each year thereafter until all
14 liabilities of the fund have been eliminated, to the degree
15 that such premiums and assessments are greater than 110% of
16 the premiums and assessments in effect during the previous
17 calendar year. The commissioner shall determine the amount
18 available for this purpose.
19 (4) Payment of the patient safety discount as
20 established in section 312. The amount available for this
21 purpose shall be determined by the commissioner and shall
22 only be authorized if there are sufficient funds available
23 after satisfying the obligations under paragraphs (1), (2)
24 and (3).
25 (c) Responsibilities of commissioner.--In order to carry out
26 the purposes of this section, the commissioner shall:
27 (1) Certify classes of health care providers by
28 specialty, subspecialty or type of health care provider
29 within a geographic classification, whose average medical
30 malpractice premium, as a class, on or after January 1, 2008,
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1 is in excess of an amount per year as determined by the
2 commissioner in accordance with subsection (b)(3).
3 (2) Establish a methodology and procedures for
4 determining eligibility for and providing payments from the
5 fund in accordance with subsection (b)(3).
6 (3) Upon certification of eligibility, the commission
7 shall notify and send to the applicable health care
8 provider's insurance carrier or self-insured program the
9 appropriate amount from the fund, and the insurance carrier
10 or self-insured provider shall provide a rebate or credit
11 equal to such payment.
12 (4) Take all necessary action to recover the cost of the
13 subsidy provided to a health care provider that the
14 commissioner determines to have been incorrectly provided.
15 (d) Requirements of health care providers:
16 (1) A health care provider that fails to comply with the
17 provisions of this section shall be required to repay to the
18 commissioner the amount of the subsidy, in whole or in part,
19 as determined by the commissioner.
20 (2) A health care provider who has been subject to a
21 disciplinary action or civil penalty by the practitioner's
22 respective licensing board is not eligible for a subsidy from
23 the fund.
24 (c) Transfer of assets and liabilities.--
25 (1) The money in the Health Care Provider Retention
26 Program established in section 1112 is transferred to the
27 fund effective January 1, 2009.
28 (2) The liabilities and obligations of the Health Care
29 Provider Retention Program under section 1112 are transferred
30 to and assumed by the fund effective January 1, 2009.
20070S1196B1626 - 6 -
1 Section 6. This act shall take effect immediately.
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